Comparing population-level mental health of UK workers before and during the COVID-19 pandemic: a longitudinal study using Understanding Society

Publication type

Journal Article


Publication date

March 16, 2022


Objectives: The COVID-19 pandemic has substantially affected workers’ mental health. We investigated changes in UK workers’ mental health by industry, socioeconomic class and occupation and differential effects by UK country of residence, gender and age.

Methods: We used representative Understanding Society data from 6474 adults (41 207 observations) in paid employment who participated in pre-pandemic (2017–2020) and at least one COVID-19 survey. The outcome was General Health Questionnaire-12 (GHQ-12) caseness (score: ≥4). Exposures were industry, socioeconomic class and occupation and are examined separately. Mixed-effects logistic regression was used to estimate relative (OR) and absolute (%) increases in distress before and during pandemic. Differential effects were investigated for UK countries of residence (non-England/England), gender (male/female) and age (younger/older) using three-way interaction effects.

Results: GHQ-12 caseness increased in relative terms most for ‘professional, scientific and technical’ (OR: 3.15, 95% CI 2.17 to 4.59) industry in the pandemic versus pre-pandemic period. Absolute risk increased most in ‘hospitality’ (+11.4%). For socioeconomic class, ‘small employers/self-employed’ were most affected in relative and absolute terms (OR: 3.24, 95% CI 2.28 to 4.63; +10.3%). Across occupations, ‘sales and customer service’ (OR: 3.01, 95% CI 1.61 to 5.62; +10.7%) had the greatest increase. Analysis with three-way interactions showed considerable gender differences, while for UK country of residence and age results are mixed.

Conclusions: GHQ-12 caseness increases during the pandemic were concentrated among ‘professional and technical’ and ‘hospitality’ industries and ‘small employers/self-employed’ and ‘sales and customers service’ workers. Female workers often exhibited greater differences in risk by industry and occupation. Policies supporting these industries and groups are needed.

Published in

Journal of Epidemiology and Community Health






Online Early

© Author(s) (or their employer(s)) 2022. Re-use permitted under CC BY. Published by BMJ.

This is an open access article distributed in accordance with the Creative Commons Attribution 4.0 Unported (CC BY 4.0) license, which permits others to copy, redistribute, remix, transform and build upon this work for any purpose, provided the original work is properly cited, a link to the licence is given, and indication of whether changes were made. See:



Latest findings, new research

Publications search

Search all research by subject and author


Researchers discuss their findings and what they mean for society


Background and context, methods and data, aims and outputs


Conferences, seminars and workshops

Survey methodology

Specialist research, practice and study

Taking the long view

ISER's annual report


Key research themes and areas of interest